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Veterans Affairs — just facts, no hyperbole: Letter to the Editor

The fact is that most of the people in the Department of Veterans Affairs are ethical and competent. The remainder of this opinion piece is not meant to criticize them.

By definition reform is change meant to improve something. Many of the processes in place need reform and some people simply have to go.

The new secretary of Veteran Affairs, Dr. David Shulkin, is tasked with reforming and managing the VA, a large bureaucracy that by its very nature will resist change even when it is designed for improvement.

If I were a political cartoonist I would sketch a picture of Shulkin in his office tied up with red tape labeled with words describing the problems such as lack of accountability, congressional oversight, cost overruns, fraud, undeserved bonuses, union constraints, limited authority to deal with unethical behavior, abuse of whistleblowers, long wait times for patients, forced travel to distant locations for care, outdated technology and inefficiency. Entering the room with more red tape would be the politicians, lawyers and union bosses.

When I was a physician in the Veterans Affairs system from 2007 to 2010, it was cumbersome and sometimes impossible to obtain approval for transfer of care to private institutions. It was not unusual for a patient to travel more than 200 miles for care not available at his primary VA facility.

A ray of hope is President Donald Trump’s recent signing of an extension of the Veterans Choice Act that would allow more access to private care for veterans who would have to wait too long for care or travel excessive distances for care within the VA. Making this a seamless process will still require a long journey of congressional approval and administrative introduction and oversight, however.

The same is true for the recent establishment by executive order of the Office of Veterans Affairs Accountability and Whistleblower Protection. Congress has the real power here and needs to hear from constituents.

Shulkin is trying to obtain authority for immediate dismissal of employees for flagrant and clear unethical or criminal behavior. He also recently established a new website, accesstocare.va.gov, which reveals how VA hospital care compares to nearby private sector hospitals. It also compares wait times among VA clinics.

I toured the website and found some parts still under construction, but it is an important start in the right direction.

According to Shulkin, telephone calls to the suicide hotline are now being answered by a person about 99 percent of the time. Shulkin deserves accolades for this improvement.

Reforming the Department of Veterans Affairs to a status of excellence will require a Herculean effort. As we labor together (as a nation) I suggest that we only utilize facts and not succumb to heated political rhetoric and hyperbole.

The truth is bad enough and needs no embellishment. It is a fight we must pursue for the health and the dignity of our veterans.